Erectile Dysfunction: Causes, Tests, and Practical Treatments

Erectile dysfunction (ED) is when you can’t get or keep an erection firm enough for sex. It happens to men of all ages, but it’s more common as you get older. This page gives clear, useful steps: what causes ED, what doctors check, and what treatments actually help.

What causes ED and what you should check first

Physical causes are the most common. Problems with blood flow, nerves, or hormones can stop an erection. High blood pressure, diabetes, heart disease, obesity, and low testosterone are usual suspects. Certain medicines — like some blood pressure drugs, antidepressants, and prostate meds — can also cause ED. Don’t forget lifestyle factors: smoking, heavy alcohol use, poor sleep, and being inactive make ED worse.

Mental health matters too. Stress, anxiety, and depression can block arousal. Performance anxiety creates a cycle: worrying about erections makes them less likely. If your ED started after a major life event or changes in mood, mental health could be the main issue.

How doctors diagnose ED and simple tests

A doctor will start with questions: your medical history, medications, and sexual history. Expect basic checks: blood pressure, weight, and a brief physical exam. Blood tests often look at glucose (for diabetes), cholesterol, and testosterone. Sometimes doctors will suggest more specific tests, like ultrasound to check blood flow or overnight erection tests to separate physical from psychological causes.

If you’re worried about privacy, telehealth can handle initial screening and prescriptions for first-line treatments. Still, an in-person visit may be needed if tests or specialist care are recommended.

Treatment depends on the cause. If a medicine is the problem, switching drugs can help. If blood flow or hormones are involved, addressing those health issues often improves erections.

PDE5 inhibitors — sildenafil (Viagra), tadalafil (Cialis), and similar drugs — are the most used pills. They work for many men but won’t be safe with nitrates used for chest pain. Side effects are usually mild: headache, flushing, or nasal congestion. If pills don’t work, other options include vacuum pumps, penile injections, and surgical implants for severe cases. Counseling or sex therapy helps when anxiety or relationship issues play a role.

Simple lifestyle changes make a big difference: quit smoking, cut back on alcohol, move more, lose excess weight, and sleep better. These steps improve heart health and often improve ED without extra treatment.

If ED affects your confidence or relationship, talk to a doctor. Early testing can catch hidden health problems like diabetes or heart disease. Treatments work — many men regain satisfying sex life with the right approach.